Cognitive Enhancement Therapy for Autism

(PerspectivesII Trial)

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Disqualifiers: Organic brain syndrome, Untreated ADHD, Personality disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 18 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two psychological treatments to help adults with autism manage challenges in thinking, planning, and social skills. Cognitive Enhancement Therapy involves cognitive training and social-cognitive group sessions to improve social understanding. Enriched Supportive Therapy focuses on managing emotions and stress while enhancing everyday social skills. Suitable participants have autism, face significant social and cognitive challenges, and can attend weekly sessions in Pittsburgh, PA. As an unphased trial, this study offers a unique opportunity to contribute to groundbreaking research and potentially benefit from innovative therapies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that Cognitive Enhancement Therapy (CET) is generally well-tolerated by adults with autism. Studies have found that CET can improve thinking and social skills without causing major side effects. This therapy includes activities like computer-based exercises and group sessions to enhance understanding of social situations.

Evidence from past studies suggests that Enriched Supportive Therapy (EST) is also a safe option. EST helps manage stress and emotions by teaching coping strategies, and participants have not reported significant negative effects.

Both therapies focus on providing support and building skills, making them gentle and safe for participants. Overall, these treatments aim to improve daily life skills without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about Cognitive Enhancement Therapy (CET) for autism because it offers a fresh approach to tackling cognitive and social difficulties. Unlike traditional therapies, which often focus solely on behavioral strategies, CET combines computer-based cognitive training with social-cognitive group sessions. This dual approach aims to enhance thinking, planning, and socialization skills by helping participants understand social cues and anticipate social outcomes. Meanwhile, Enriched Supportive Therapy stands out by providing personalized support to manage stress and improve emotional regulation. Together, these therapies offer innovative strategies to help individuals with autism better navigate daily life.

What evidence suggests that this trial's treatments could be effective for autism?

Research has shown that Cognitive Enhancement Therapy (CET), one of the treatments in this trial, can help adults with autism improve their thinking and planning skills. Studies have found that participants in CET become better at adjusting to new information and situations, known as cognitive flexibility. This improvement can lead to enhanced social skills and job opportunities.

Enriched Supportive Therapy (EST) is another treatment option in this trial. It aids adults with autism by managing emotions and stress, improving social skills, and handling daily challenges. Although fewer detailed studies exist on EST's effectiveness for autism, it is designed to help individuals understand and manage their condition. Together, these therapies offer promising ways to enhance various aspects of life for adults with autism. ^{1 5 6 7 8}

Who Is on the Research Team?

Nancy J Minshew, Ph.D.

Principal Investigator

University of Pittsburgh

Shaun M Eack, Ph.D.

Principal Investigator

University of Pittsburgh

Are You a Good Fit for This Trial?

Adults aged 16-45 with autism, Asperger's syndrome, or pervasive developmental disorder not otherwise specified (NOS), who have an IQ over 80 and significant social/cognitive challenges. Participants must speak English fluently, be able to attend sessions in Pittsburgh, PA, and have a supportive person for information sharing.

Inclusion Criteria

Ability to read and speak fluent English

I am between 16 and 45 years old.

I can go to weekly treatment sessions in Pittsburgh, PA.

Exclusion Criteria

Organic brain syndrome

History of disruptive or violent behavior

I have ADHD that has not been treated.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Cognitive Enhancement Therapy (CET) or Enriched Supportive Therapy (EST) for 18 months

18 months

Weekly visits (in-person)

Follow-up

Participants are monitored for the lasting impact of the study interventions

12 months

Periodic assessments (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Cognitive Enhancement Therapy
• Enriched Supportive Therapy

Trial Overview The trial is testing Cognitive Enhancement Therapy (CET) against Enriched Supportive Therapy (EST). CET focuses on improving thinking and social skills while EST helps with understanding the condition, managing emotions/stress, enhancing social abilities, and problem-solving.

How Is the Trial Designed?

Group I: Cognitive Enhancement Therapy Experimental Treatment 1 Intervention

This research treatment aims to help with problems in thinking, planning, and socialization. Participants begin with cognitive training using computer software programs. They also participate in a small social-cognitive group to learn about their condition and how to act wisely in social situations by developing the abilities needed to understand another person's perspective, evaluate social contexts, and be foresightful. Time commitment: about 3½ hours per week; Location: Pittsburgh, PA only

Group II: Enriched Supportive Therapy Active Control 1 Intervention

This research treatment uses individual supportive therapy to help adults learn about autism spectrum disorder, manage their emotions and stress, improve their social skills, and cope with everyday problems. Participants will learn about the impact of stress on their lives, and how to identify their own early cues of distress and apply effective coping strategies. Time commitment: about 1 hour per week; Location: Pittsburgh, PA only

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

Cognitive enhancement therapy (CET) significantly improved overall cognition in patients with early-course schizophrenia over an 18-month period, as confirmed by a study involving 102 outpatients.

While CET showed promising effects on social cognition and attention, it did not significantly outperform enriched supportive therapy (EST) in improving social adjustment, although the benefits appeared to increase for those who completed the treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Confirmatory Efficacy of Cognitive Enhancement Therapy for Early Schizophrenia: Results From a Multisite Randomized Trial. Wojtalik, JA., Mesholam-Gately, RI., Hogarty, SS., et al.[2023]

Cognitive Remediation Therapy (CRT) significantly improved executive functions and school performance in children and adolescents with Autism Spectrum Disorder (ASD), with 16 out of 25 participants completing an average of 22 sessions.

After CRT, participants showed notable enhancements in intellectual abilities, working memory, and specific aspects of cognitive flexibility, indicating that CRT is a promising intervention for addressing cognitive impairments associated with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive remediation therapy in autism spectrum disorder: Tunisian experience. Hajri, M., Abbes, Z., Ben Yahia, H., et al.[2020]

Cognitive enhancement therapy (CET) for first-episode schizophrenia effectively combines supportive therapy with social skills and cognitive training, aiming to improve cognitive and negative symptoms in a motivational format.

The therapy emphasizes a strong therapeutic alliance, allowing clinicians to use techniques like errorless learning and positive reinforcement, making it adaptable for both group and individual treatment settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive enhancement therapy: a therapeutic treatment strategy for first-episode schizophrenia patients. Miller, R., Mason, SE.[2019]

Cognitive Enhancement Therapy (CET) showed sustained improvements in cognitive and social functioning one year after treatment in individuals with schizophrenia, based on a study of 121 participants.

Early improvements in processing speed were identified as a key factor mediating the long-term benefits of CET on social cognition and adjustment, suggesting that enhancing this cognitive aspect may be crucial for ongoing therapeutic effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Durability and mechanism of effects of cognitive enhancement therapy. Hogarty, GE., Greenwald, DP., Eack, SM.[2019]

Cognitive Enhancement Therapy (CET) aims to improve social cognition in schizophrenia patients by using interactive software and group exercises, focusing on abstract thinking and social context understanding.

Preliminary observations suggest that CET effectively addresses cognitive deficits related to social interactions, potentially helping patients manage symptoms of schizophrenia more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Practice principles of cognitive enhancement therapy for schizophrenia. Hogarty, GE., Flesher, S.[2019]

Cognitive remediation therapy (CRT) has shown cognitive performance improvements in patients with eating disorders, regardless of their level of autistic characteristics, indicating its broad applicability.

This preliminary study supports the feasibility and benefits of individual CRT for patients exhibiting features of autism spectrum disorder, suggesting it can enhance cognitive functioning in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual cognitive remediation therapy benefits for patients with anorexia nervosa and high autistic features. Dandil, Y., Smith, K., Adamson, J., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5867220/

Cognitive Enhancement Therapy for Adult Autism ... This study examined the efficacy of Cognitive Enhancement Therapy (CET) for improving core cognitive and employment outcomes in adult autism.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT00902798

Cognitive Enhancement Therapy for Adult Autism ... This study will investigate and contrast the effects of two psychological treatments for adults with autism spectrum disorder. Cognitive Enhancement Therapy ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/29286586/

Cognitive enhancement therapy for adult autism ... - PubMed This study examined the efficacy of cognitive enhancement therapy (CET) for improving core cognitive and employment outcomes in adult autism.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT03170453

Confirmatory Efficacy Trial of Cognitive Enhancement ... This study will investigate and confirm the efficacy of two psychological treatments for adults with autism spectrum disorder. Cognitive Enhancement Therapy ...

5. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.00722/full

Cognitive Remediation Interventions in Autism Spectrum ... The results indicate that participants with high autistic features showed significant improvements in cognitive flexibility (p <0.001) after ...

6. reporter.nih.gov reporter.nih.gov/project-details/8979854

Cognitive Enhancement Therapy for Adult Autism Spectrum ... Such evidence suggests that CET has considerable promise as an evidence-based cognitive rehabilitation intervention for adult ASD, and it is critical that these ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S1878747923001654

An Update on Psychopharmacological Treatment of Autism ... In this article, we provide a review of current psychopharmacological treatment in ASD including those used to address common comorbidities of the condition.

8. asatonline.org asatonline.org/research-treatment/research-synopses/cognitive-enhancement-therapy/

Cognitive Enhancement Therapy - ASAT Online Cognitive remediation shows promise for improving cognitive impairments in adults diagnosed with ASD. CET was effective for enhancing neurocognitive function, ...